Improving access to mental health services – it’s time to act now

Whilst I disagree fundamentally with many of the government’s reforms to the NHS, a distraction and expense the health service does not need, there is one commitment I do support and one for which ministers must firmly be held to account.

Ed Jacobs writes in a personal capacity. His petition calling for a guarantee of access to appropriate mental health treatment within 28 days is available online.  

Whilst I disagree fundamentally with many of the government’s reforms to the NHS, a distraction and expense the health service does not need, there is one commitment I do support and one for which ministers must firmly be held to account.

In November, the care services minister, Norman Lamb, said that those waiting for mental health treatment should not find themselves waiting longer than those for physical problems.

This is a good start, but ministers and shadow ministers alike should be committing, on a cross party basis to a much more radical policy, as advocated by charities such as Mind, for a new  guarantee  that those requiring it should be able to access appropriate mental health therapies in a maximum of 28 days from the date of referral.

Whilst I appreciate that NHS resources are scarce, for those who conclude that such an ambition is not realistic, I would argue that we simply cannot afford not to on both economic and social grounds.

Writing for the “Time to Change” campaign, one sufferer has written of their own mental health difficulties:

“When I was a teenager, I spent time in a child psychiatric unit and when I came out, the kids near where I lived found out. Over the next few years, every time I left the house I would be attacked and have abuse shouted at me. As a result, I started to go out less and less. This led to over a decade of having no social life.”

Such a situation is not uncommon. Facing a serious mental health condition that is every bit as real as a physical illness, too many people then have their problems compounded by bullying triggered by the misunderstandings of those around them, leading often to withdrawal and isolation.

Now just think about that sufferer. They might be on medication to help, but it is largely accepted that talking therapies such as counselling or Cognitive Behavioural Therapy can be amongst the most appropriate forms of longer term treatment and support. How cruel it is therefore to leave sufferers often for months on end waiting for referral to appropriate treatment?

Just last year, a study by experts at the London School of Economics declared it to be a “scandal that we have 6,000,000 people with depression or crippling anxiety conditions and 700,000 children with problem behaviours, anxiety or depression. Yet three quarters of each group get no treatment.”

It went on to note that a majority of those suffering from depression waited more than six months, while median waiting times for physical treatment were less than three weeks.

To use the LSE’s words, how scandalous it is that Britain, supposedly one of the world’s richest countries, can allow those suffering from mental health problems to wait so long for treatment, during which time those suffering can deteriorate dramatically, which, on a crude level, serves only to ramp up the costs still further to the NHS.

Indeed, it is perhaps idle speculation, but with rates of suicide reported to have significantly increased last year, how many of these people could perhaps have been saved with swifter access to appropriate therapy?

But it goes further than an argument which seeks only to tug on heart strings for want of a better phrase. Speeding up access to treatment is also a vital economic stimulus that we can ill afford to ignore.

The cost to England’s economy of mental ill health is thought to be over £100 billion a year. Yes, that’s £100 billion a year. And if we delve deeper, figures from the Centre for Mental Health show that the total cost to employers of mental health problems among their staff is estimated to be nearly £26 billion each year, equivalent to £1,035 for every employee in the UK workforce.

This is made up of £8.4 billion in sickness absence; £15.1 billion a year in reduced productivity at work and £2.4 billion a year in replacing staff who leave their jobs because of mental ill health. How much money is being wasted by Government and business in a time of austerity by leaving those with mental health trouble to languish for months on end on waiting lists for treatment?

This is a clear case of social and economic concerns fusing together.

And for those who argue that it would be too greater cost for the NHS to bear if a guarantee to treatment was introduced, just read the words of the LSE report published last year, which concluded:

“More expenditure on the most common mental disorders would almost certainly cost the NHS nothing. For mental illness often increases the scale of physical illness. It can make existing physical illness worse. And it can also cause physical symptoms which cannot be medically explained at all: a half of all NHS patients referred for first consultant appointments in the acute sector have “medically unexplained symptoms”.

Altogether the extra physical healthcare caused by mental illness now costs the NHS at least £10 billion. Much of this money would be better spent on psychological therapies for those people who have mental health problems on top of their physical symptoms. When people with physical symptoms receive psychological therapy, the average improvement in physical symptoms is so great that the resulting savings on NHS physical care outweigh the cost of the psychological therapy.”

One in four of us will at some stage suffer from a mental health problem, many of whom will require treatment and support. For the sake of both the social and economic fabric of our country, the Cinderella service that mental health has too often become needs addressing once and for all with a pledge by all parties to support a guarantee of access to appropriate treatment within 28 days.

As a society we would do well to heed the advice of Barack Obama who, two years before winning the presidency, said in a Commencement Address to Xavier University:

“You know, there’s a lot of talk in this country about the federal deficit. But I think we should talk more about our empathy deficit – the ability to put ourselves in someone else’s shoes; to see the world through the eyes of those who are different from us – the child who’s hungry, the steelworker who’s been laid-off, the family who lost the entire life they built together when the storm came to town.”

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4 Responses to “Improving access to mental health services – it’s time to act now”

  1. LB

    how scandalous it is that Britain, supposedly one of the world’s richest countries, can allow those suffering from mental health problems to wait so long for treatment

    ==============

    We aren’t. We are bankrupt.

    7,000 bn of debts.

    550 bn of taxes

    700 bn of spending.

    Which bit don’t you understand?

    ==============

    On the mental health issues, you are reasonably accurate with the assessment. It’s widespread.

    However, nothing will change, because you’ve run up the debts that can’t be paid.

    ie.

    1. Pay pensions (reduced)
    2. Have a health service. (reduced)

    Pick one of 2.

  2. Amabassador Spock

    Anyone who thinks this country is bankrupt is an economic illiterate. Thatcher ran a higher defecit thqn Brown who by the way paid off a large chunk of the debtshe ran up. However the favt is that as the article pointed out. In the long term more and appropriate mental health spending will stimulate the economy and more than pay for itself. One thing a lot of the people tbat the article draws from seem to miss though is that even when you get the help you need. You only get it for a short period. So just as its starting to work its withdrawn as youve had your 10 sessions and your back on your own again. So we shouldnt just be calling for a guarantee that people get treatment within 28 days put that the treatment will last as long as they need it and the wnding of counselling is assesed by a patients advocate so that they arent declared cured or fit or however you want to put it before they are just to save money or make the ‘resource’ go further

  3. Cheryl Smith

    Great article Ed! As someone who works in an IAPT service we have faced severe budget cuts leading to increases in wait times. Our counselling wait time 4 years ago was only 2 weeks, it is now 12 weeks. To combat this, we have been told to reduce session times with clients which in my opinion can often mean that the client feels rushed, not listened to and the session overall less productive. Sadly, waiting times have not decreased, as due to the economy at present we are receiving more and more referrals.

    We have recently lost all our admin due to further budget cuts, meaning as well as seeing clients we must do all admin ourselves reducing the amount of time we can use to see clients. It has forced us to often only be able to offer clients one appointment every 5-6 weeks whereas previously this would have been fortnightly.
    I get the impression the current government want to force GPs into feeling the NHS offers a poor service, and therefore force their hand to find services from private sources instead.
    We often refer to our IAPT service as ‘The Titanic’ – something once seen as great and majestic, that has since hit an iceberg and become a sinking ship.

  4. dan

    been waiting for mental heath service in the north of the country for allmost a year its no wonder the suicide rate is so high for young aged people

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